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bijps-1538
A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#
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Abstract

Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions.

Objective:

compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection.

Patients and method:

The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021).

The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis.

The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups.

Results and discussion:

two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin.

COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05).

Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day.

Conclusion:

Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.

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Publication Date
Tue Sep 15 2015
Journal Name
Alustath Journal For Human And Social Sciences
The Degree of Satisfaction of Secondary School Principals with the Role of Universities and their Obstacles in Developing their Administrative Skills
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    A field study aimed at identifying the degree of satisfaction of secondary school principals with regard to the role of universities and their obstacles in developing their administrative skills. It adopted the descriptive analytical approach. The research community consisted of (249) male and female principals in the schools of Baghdad (Al-Rusafa and Karkh), and the research sample was chosen by the simple random stratified method at a percentage of (40%) of the research community, and the number of the sample was (100) male and female principals. A questionnaire consisting of (40) items distributed between two domains was developed. Its validity and reliability were confirmed. The researcher used the (SPS

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The effectiveness of teaching the theory of TRIZ in expressive performance and the development of creative thinking among preparatory school students
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The current research aims to find out (the effectiveness of teaching TRIZ theory in the expressive performance and the development of creative thinking among preparatory school students)
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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
Structural-Semantic and Stylistic Characteristics of the New Idioms in Russian Language: Структурно-семантическая и стилистическая характеристика новых фразеологизмов русского языка
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This study is dedicated to one of the most difficult topics in Russian - this is the science of idioms. A feature of the Russian speech application in recent decades has been the effective change in the lexical composition of the Russian language. This article illustrates the semantic, grammatical and stylistic structural characteristics of the linguistic units that appeared in Russian at the end of the 20th century - the beginning of the twenty-first century. This work defines these terms : terminology, linguistic unity, and terms that are used as synonyms. In this research , we will adhere to the conciliatory view of the problem and include not only the terminology in the language units, but also the terminological compositions, saying

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Publication Date
Mon Apr 22 2019
Journal Name
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Evaluation of Gas and Downhole Water Sink-Assisted Gravity Drainage GDWS-AGD Process in Saturated Oil Reservoirs with Infinite-Acting Aquifer
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Abstract<p>A hybrid Gas-Enhanced and Downhole Water Sink-Assisted Gravity Drainage (GDWS-AGD) process has been suggested to enhance oil recovery by placing vertical injectors for CO2 at the top of the reservoir with a series of horizontal oil-producing and water-drainage wells located above and below the oil-water contact, respectively. The injected gas builds a gas cap that drives the oil to the (upper) oil-producing wells while the bottom water-drainage wells control water cresting. The hybrid process of GDWS-AGD process has been first developed and tested in vertical wells to minimize water cut in reservoirs with bottom water drive and strong water coning tendencies. The wells were dual-compl</p> ... Show More
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Publication Date
Tue Aug 24 2021
Journal Name
Agronomy
Impact of Nitrogen Rate in Conventional and Organic Production Systems on Yield and Bread Baking Quality of Soft Red Winter Wheat
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Soft red winter wheat (SRW) is characterized by high yield and relatively low protein content. In Kentucky, there is growing demand from local artisan bread bakers for regionally produced flour, requiring production of grain with increased protein content and/or strength. The objective of this two-year field experiment was to evaluate the effect of nitrogen (N) management on five cultivars of winter wheat on yield and bread baking quality traits of modern and landrace SRW cultivars (Triticum aestivum L.). All five cultivars were evaluated using two N application rates in conventional and organic production systems. All traits measured were significantly affected by the agricultural production system and N rate, although plant height

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Sun Mar 19 2023
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The Effect of the Alternative Evaluation Strategy on the Achievement of Fourth-Grade Female Science Students in the Subject of Biology
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Publication Date
Fri Nov 28 2025
Journal Name
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Dissolution of inorganic phosphorous ion from human enamel treated with different concentration of Siwak aqueous extract in comparison with sodium fluoride
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Background: The use of Miswak, chewing sticks (salvadorapersica) can be traced back to Babylonians some 7000 years ago. It is commonly used throughout the world especially for the purpose of oral hygiene. Muslims are using as the religious view. Current study aimed to test the ability of aqueous siwak extract to increase the resistance of enamel surface against acid dissolution compared to sodium fluoride. Materials and Method: Twenty maxillary first premolars were treated with the selected solutions included two aqueous siwak extract concentration(5%,10%) and sodium fluoride(0.05%)as control positive for 2 minutes once daily for 20days interval, de ionized water was used as control negative. The concentration of the dissolved phosphorus i

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Publication Date
Thu May 18 2023
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The Effect of Tool Path Strategy on Mechanical Properties of Brass (65-35) in Single Point Incremental Sheet Metal Forming (SPIF)
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In this paper, three tool paths strategies; iso-planar, helical and adaptive have been implemented to investigates their effect on the mechanical properties of Brass 65-35 formed by single point incremental sheet metal forming process. To response this task, a fully digital integrated system from CAD modeling to finished part (CAD/CAM) for SPIF process has been developed in this paper.
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Publication Date
Sun Jul 09 2023
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Dynamic Behavior of Pb(II) and Cr(III) Biosorption onto Dead Anaerobic Biomass in Fixed-Bed Column, Single and Binary Systems
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The biosorption of lead (II) and chromium (III) onto dead anaerobic biomass (DAB) in single and binary systems has been studied using fixed bed adsorber. A general rate multi- component model (GRM) has been utilized to predict the fixed bed breakthrough curves for single and dual- component system. This model considers both external and internal mass transfer resistances as well as axial dispersion with non-liner multi-component isotherm (Langmuir model). The effects of important parameters, such as flow rate, initial concentration and bed height on the behavior of breakthrough curves have been studied. The equilibrium isotherm model parameters such as maximum uptake capacities for lead (II) and chromium (III) were found to be 35.12 and

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Publication Date
Thu Nov 08 2018
Journal Name
Chemistry – A European Journal
Magnetic Shielding, Aromaticity, Antiaromaticity and Bonding in the Low‐Lying Electronic States of S <sub>2</sub> N <sub>2</sub>
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Aromaticity, antiaromaticity and chemical bonding in the ground (S0), first singlet excited (S1) and lowest triplet (T1) electronic states of disulfur dinitride, S2N2, were investigated by analysing the isotropic magnetic shielding, σiso(r), in the space surrounding the molecule for each electronic state. The σiso(r) values were calculated by state-optimized CASSCF/cc-pVTZ wave functions with 22 electrons in 16 orbitals constructed from gauge-including atomic orbitals (GIAOs). The S1 and T1 electronic states were confirmed as 11Au and 13B3u, respectively, through linear response CC3/aug-cc-pVTZ calculations of the vertical excitation energies for eight singlet (S1–S8) and eight triplet (T1–T8) electronic states. The aromaticities of S

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